SynthesisJournal of orthopaedic surgery and research2025
Orthopedic frailty risk stratification (OFRS): a systematic review of the frailty indices predicting adverse outcomes in orthopedics.
Synthesis in Journal of orthopaedic surgery and research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed.
- Association of frailty indices with post-operative outcomes in shoulder surgery: a systematic review.JSES reviews, reports, and techniques · 2026Review
- In older adults undergoing surgical fixation or arthroplasty following upper limb fractures, does frailty predict post-operative complications and mortality? A systematic review and meta-analysis.JSES reviews, reports, and techniques · 2026Review
- Risk analysis index demonstrates superior predictive performance compared to traditional frailty metrics in elderly female patients undergoing inpatient total shoulder arthroplasty.Arthroplasty (London, England) · 2026Article
- Association of frailty with fragility fractures and all‑cause mortality in adults: evidence from the National Health and Nutrition Examination Survey.BMC musculoskeletal disorders · 2026Article
- Predictive Performance of Frailty Indices for Complications and Functional Recovery After Distal Radius Fracture Surgery in Patients Aged ≥65 years.Geriatric orthopaedic surgery & rehabilitation · 2026Article
- Frailty: An overlooked red flag in sports surgery.Journal of experimental orthopaedics · 2025Article
- Trochlear cartilage status at second-look arthroscopy predicts 2-year outcomes after around-knee osteotomy, especially in older patients.Journal of experimental orthopaedics · 2025Article
- Mediation of the frailty index, the relationship between sleep duration and chronic pain in different body regions: insights from the CHARLS cross-sectional study.Journal of orthopaedic surgery and research · 2025Article
- The Impact of Frailty Indices on Predicting Complications and Functional Recovery in Proximal Humerus Fractures: A Comparative Study.Medicina (Kaunas, Lithuania) · 2025Article
- CORR Insights®: Frailty Is Associated With Increased 30-day Readmissions and Costs After Total Shoulder Arthroplasty.Clinical orthopaedics and related research · 2025Article
- Comparative Analysis of Frailty Indices on Complication Risk Following Septic Revision Total Hip and Knee Arthroplasty.Geriatric orthopaedic surgery & rehabilitation · 2025Article
- Comparative effects of ciprofol and propofol on perioperative hemodynamics during hip arthroplasty in older adults with frailty: A prospective randomized controlled trial.Journal of anaesthesiology, clinical pharmacologyArticle
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12 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundWith a growing number of elderly patients requiring elective and non-elective procedures, frailty-based preoperative risk stratification is an emerging tool in orthopedic surgery to minimize adverse postoperative outcomes. This paper sought to understand the current literature regarding preoperative Orthopedic Frailty Risk Stratification (OFRS) and describe the disparate frailty indices and their capabilities for discrimination in predicting adverse postoperative outcomes.
methodsA literature search was conducted in Pubmed, Cochrane, and Scopus for articles published during or prior to February 2024 assessing frailty following surgery for orthopedic pathologies. Qualitative variables including study characteristics and application of frailty were collected and synthesized. Quantitative meta-analysis was performed for pooled odds ratio (OR) and area under the curve (AUC) of frailty for mortality and complications. All methods were performed in accordance with PRISMA guidelines.
resultsOf the 81 included articles, over half (52%) addressed traumatic orthopedic pathologies with traumatic hip fractures being the most studied in the OFRS (25 studies). Less common categories included oncology, sports, and foot/ankle. Functional status and independence were the most common frailty domain (25, 96.2%) and component across scales (20, 76.9%), respectively. The 5-Item Modified Frailty Index (mFI-5) was the most common frailty index (28 publications). Meta-analysis demonstrated increasing frailty was an independent predictor of mortality (30-day OR: 2.89, 95% CI: 2.00-4.18; 1 year OR: 1.81, 95% CI: 1.48-2.22, p < 0.001), major complications (OR: 1.63, 95% CI: 1.10-2.41, p = 0.02), and Clavien-Dindo IV complications (OR: 3.26, 95% CI: 2.18-4.87, p < 0.001). Frailty had good discriminatory accuracy for predicting mortality at 30-days (AUC: 0.71, 95% CI: 0.68-0.74, p < 0.001), 3-months (OR: 0.75, 95% CI: 0.65-0.83, p < 0.001), and 1-year (OR:0.74, 95% CI: 0.73-0.75, p < 0.001).
conclusionsThe orthopedic surgery frailty literature is extremely heterogeneous, with disparate frailty scales implemented to measure varying outcomes across many orthopedic pathologies. Despite no consensus on exact scales or definitions, various frailty indices have predicted adverse outcomes.
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